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TEMPORARY FOOD VENDOR’S APPLICATION <br />1. <br />2. <br />Address: <br />3. <br />4. <br />5. <br />6. <br />7. <br />8. <br />9. <br />meats, tamales, cooked beans, rice, <br />9 <br /> Camp stove <br /> Double steamer <br /> Electric stove top <br /> Sterno & hotel trays <br /> Steam table & lids <br /> Other (specify) <br />Note: Examples of potentially hazardous food include: <br />vegetables, potato salad, eggs, and dairy products. <br />COMPLETE BOTH SIDES AND RETURN WITH EXHIBITOR AGREEMENT <br />~~ ft 'tA 7 <br />providing a booth with the following: (to protect my unpackaged food and food-preparation areas from flies, <br />Phone: <br />Note: The only operations not required to provide enclosed booths are those which sell beverages from <br />approved dispensers, or prepackaged foods from approved sources. <br />Approved water for drinking, utensil and hand washing will be provided in my booth by the following methods: <br /> Approved bottled water. <br />El On-site hose bib that is connected to a potable water source. <br />^BOther (specify): <br />Electricity is provided for my booth’s use: Yes No <br />I am providing an accurate probe thermometer to measure the hot and cold holding of potentially hazardous <br />foods during all times of booth operation: Yes No <br />I am providing the following hot temperature control for the hot holding of all potentially hazardous foods above <br />j. bcx'C <br />All food vendors (both for profit and non-profit) are required to return a signed and completed copy of this checklist to <br />the festival coordinator three (3) weeks prior to this event. <br /> 1. Name of Event:...VUMm Y.m*;Date(s);i?,|m -U2-E <br />The following is information about my organization/business: <br />Name of organization/business: OI \ v/i *5 e-g <W\ <br />PjdWgr cM <br />Phone: " 6 7 Alternate: ( ) <br />List food to be sold or given to the public:C V) ? q q <br />I am providing food that is NOT prepared at home: Yes No <br />All food is prepared on-site or is from approved commercial facilities: 0 Yes No <br />Name of facility: ~ Cp-YVck-CAr? ’■ -■ <br />Address of facility: T H 'T* ? <zL 11 \ p f <br />I am | ............................. - " <br />dust and the public) <br />S'A booth with walls and ceiling constructed of either wood, canvas, plastic, similar material and fine mesh fly <br />screening, completely enclosing open food areas. It will also have a smooth and cleanable floor (concrete, <br />asphalt, clean tarps and smooth wood are acceptable) and constructed to separate food and food preparation <br />areas from the public. <br /> Other (specify):________________ _______________________